Neuroprotective Core Measure 2: Partnering with Families - Effects of a Weighted Maternally-Scented Parental Simulation Device on Premature Infants in Neonatal Intensive Care

NICU sensory experiences associated with positive outcomes: an integrative review of evidence from 2015-2020

To inform changes to the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, studies investigating sensory-based interventions in the NICU with preterm infants born ≤32 weeks were identified. Studies published between October 2015 to December 2020, and with outcomes related to infant development or parent well-being, were included in this integrative review. The systematic search used databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and Google Scholar. Fifty-seven articles (15 tactile, 9 auditory, 5 visual, 1 gustatory/olfactory, 5 kinesthetic, and 22 multimodal) were identified. The majority of the sensory interventions that were identified within the articles were reported in a previous integrative review (1995-2015) and already included in the SENSE program. New evidence has led to refinements of the SENSE program, notably the addition of position changes across postmenstrual age (PMA) and visual tracking starting at 34 weeks PMA.

Supporting and Enhancing NICU Sensory Experiences (SENSE), 2nd Edition: An Update on Developmentally Appropriate Interventions for Preterm Infants

The Supporting and Enhancing NICU Sensory Experiences (SENSE) program promotes consistent, age-appropriate, responsive, and evidence-based positive sensory exposures for preterm infants each day of NICU hospitalization to optimize infant and parent outcomes. The initial development included an integrative review, stakeholder input (NICU parents and healthcare professionals), and feasibility focus groups. To keep the program updated and evidence-based, a review of the recent evidence and engagement with an advisory team will occur every 5 years to inform changes to the SENSE program. Prior to the launch of the 2nd edition of the SENSE program in 2022, information from a new integrative review of 57 articles, clinician feedback, and a survey identifying the barriers and facilitators to the SENSE program's implementation in a real-world context were combined to inform initial changes. Subsequently, 27 stakeholders (neonatologists, nurse practitioners, clinical nurse specialists, bedside nurses, occupational therapists, physical therapists, speech-language pathologists, and parents) carefully considered the suggested changes, and refinements were made until near consensus was achieved. While the 2nd edition is largely the same as the original SENSE program, the refinements include the following: more inclusive language, clarification on recommended minimum doses, adaptations to allow for variability in how hospitals achieve different levels of light, the addition of visual tracking in the visual domain, and the addition of position changes in the kinesthetic domain.

Measuring experience of and satisfaction with newborn care: a scoping review of tools and measures

BACKGROUND

Standardised measures on experience of care are essential to understanding the care women and newborns receive and to designing appropriate interventions and responses. This review builds on ongoing work in the realm of maternity care and complements it by reviewing existing tools and measures to assess experience of and satisfaction with the care of the newborn.

METHODS

We conducted a scoping review of published literature to identify measures and tools of experience (physiological or indirect) and satisfaction with newborn care. We systematically searched five bibliographic databases from 1 January 2010 through 1 December 2022 and contacted professional networks. Using a predefined evidence template, we extracted data on the studies and the tools' characteristics. We mapped the tools and measures against the WHO quality of care frameworks to identify the most frequent measured domains of care and to highlight existing gaps.

RESULT

We identified 18 292 records of which 72 were eligible. An innovative finding of this review is the inclusion of newborn perspectives through behavioural responses, physiological signals, pain profiles as well as other non-verbal cues as markers of newborn experience. Domains related to parental participation and decision-making, ensuring continuity of care and receiving coordinated care, were the most measured across the included tools.

CONCLUSION

Comprehensive and validated instruments measuring all aspects of care are needed. Developing a robust theoretical ground will be fundamental to the design and utilisation of standardised tools and measures.

PROTOCOL REGISTRATION DETAILS

This review was registered and published on protocol.io (dx.doi.org/10.17504/protocols.io.bvk7n4zn).

The Effect of Neonates' Exposure to Their Mother's Scent on Weight Gain: A Randomized Controlled Study

Objective: The aim of this study was to determine the effect of newborns' exposure to their mother's scent in the intensive care unit on their weight gain. Materials and Methods: This is an experimental randomized controlled study. One hundred and four neonates were included in the study. Two groups were observed in the research: the first group consisting of those exposed to their mother's scent (n = 52) and a second control group (n = 52). Data were collected with a data collection form and an infant body weight monitoring form. Significance for the study was accepted as p < 0.05. Results: Among the neonates, 61.5% were males, the gestational week of the infants was 38.49 ± 1.24, their mean weight was 3,213.32 ± 468.67 grams (g); the two groups were similar in terms of these characteristics (p > 0.05). The neonates exposed to their mother's scent at the beginning of the study were weighed, averaging 3,105.38 ± 487.69 g; at the end of Day 1 and Day 2, their mean weight was 3,150.77 ± 493.07 and 3,197.50 ± 489.06 g, respectively. It was seen that there were significant differences in the weight of the group of neonates exposed to their mother's scent before the experiment, on Day 1 and on Day 2 (p < 0.05). The neonates in the control group were weighed at the beginning of the experiment, exhibiting a mean of 3,119.42 ± 452.85 g. Their mean weight was 3,107.12 ± 463.30 g at the end of Day 1 and 3,116.63 ± 471.09 g at the end of Day 2. These differences, however, were not statistically significant (p > 0.05). Conclusion: We found that the newborns exposed to their mother's scent in the intensive care unit registered a higher increase in weight. Our recommendation is that a mother's scent be routinely factored into neonatal care in intensive care units.

A Survey of Neonatal Clinicians' Use, Needs, and Preferences for Kangaroo Care Devices

BACKGROUND

Decades of research supports the benefits of kangaroo care (KC) for the parent and newborn. Supportive KC devices may be an important tool clinicians can use to assist parents with KC. In recent years, there has been a rise in the availability of KC devices. However, the use, needs, and preferences for these supportive devices by neonatal clinicians have not been documented.

PURPOSE

To survey clinicians' use, needs, and preferences of KC supportive devices, and examine whether differences exist based on clinician and organizational characteristics.

METHODS

A cross-sectional, online survey was sent through neonatal organization Web sites, conferences, and social media.

RESULTS

Many clinicians (n = 68, 43%; N = 158) facilitated KC with a supportive device, with 81% of devices provided by the clinician's employer. The most important "Must Have" feature of a KC device was "Safety: Reduces patient falls if caregiver sleeps or needs to use hands" (84% of respondents) followed by washability (82%), and "immediate, effective access to the baby" (78%). Clinicians' responses did not differ based on hospital setting, type of unit, KC experience, or experience using a KC device.

IMPLICATIONS FOR PRACTICE

To support safe use of KC devices in neonatal intensive care unit (NICU) clinical care, a device must hold the proper KC position consistently, allow immediate access to the infant, and hold the infant in place without the parent's hands to prevent falls. Training is needed to ensure safe device use.

IMPLICATIONS FOR RESEARCH

Future research should evaluate the safety, efficacy, and cost-effectiveness of these devices.